Search

Radiofrequency electromagnetic fields (RF‐EMF, 100 kHz to 300 GHz) are classified by IARC as possibly carcinogenic to humans (Group 2B). This study evaluates the potential association between occupational RF‐EMF exposure and brain tumor risk, utilizing for the first time, a RF‐EMF job‐exposure matrix (RF‐JEM) developed in the multi‐country INTEROCC case–control study. Cumulative and time‐weighted average (TWA) occupational RF‐EMF exposures were estimated for study participants based on lifetime job histories linked to the RF‐JEM using three different methods: (1) by considering RF‐EMF intensity among all exposed jobs, (2) by considering RF‐EMF intensity among jobs with an exposure prevalence ≥ the median exposure prevalence of all exposed jobs, and (3) by considering RF‐EMF intensity of jobs of participants who reported RF‐EMF source use. Stratified conditional logistic regression models were used, considering various lag periods and exposure time windows defined a priori. Generally, no clear associations were found for glioma or meningioma risk. However, some statistically significant positive associations were observed including in the highest exposure categories for glioma for cumulative and TWA exposure in the 1‐ to 4‐year time window for electric fields (E) in the first JEM application method (odds ratios [ORs] = 1.36, 95% confidence interval [95% CI] 1.08, 1.72 and 1.27, 95% CI 1.01, 1.59, respectively), as well as for meningioma for cumulative exposure in the 5‐ to 9‐year time window for electric fields (E) in the third JEM application method (OR = 2.30, 95% CI 1.11, 4.78). We did not identify convincing associations between occupational RF‐EMF exposure and risk of glioma or meningioma. [ABSTRACT FROM AUTHOR]

This study highlights the utility of a job-exposure matrix for evaluating sedentary behavior across diverse industries and its associations with specific health outcomes such as diabetes and endometrial cancer. It underscores the importance of industry-tailored interventions in occupational health, enhancing strategies for chronic disease prevention in the workplace. Objective: The aim of the study is to develop a job-exposure matrix for sedentary behavior and assess its relationship with noncommunicable diseases. Methods: We constructed a job-exposure matrix using occupational and industry classifications combined with data on daily average sitting durations from 41,718 individuals. This matrix was then applied to a cohort of 706,939 participants in a case-control study to explore the link between sedentary behavior and noncommunicable disease risks. Results: The matrix effectively identified sedentary behavior across different occupational groups. Using the matrix to assess sedentary behavior, associations were found between increased sedentary activity and heightened risks of diabetes, acute myocardial infarction, and endometrial cancer, while a reduced risk was observed for stroke. Conclusions: The job-exposure matrix provides valuable insights into the health impacts of sedentary behavior in the workplace, underscoring significant disease risks associated with prolonged inactivity. [ABSTRACT FROM AUTHOR]

Objectives To estimate the association between SSc clinical phenotypes and quantitative occupational exposure to crystalline silica, chlorinated solvents, trichloroethylene and pesticides using job-exposure matrices. Methods In the VISS-EXPOSITION transversal study, data on declarative occupational exposure to crystalline silica, solvents and pesticides were retrieved. In parallel, the lifetime occupational history was evaluated using a questionnaire and cursus laboris for SSc patients followed at Bordeaux University Hospital (France). Using job-exposure matrices, we assessed patients' occupational exposure in relation to relevant clinical phenotypic forms of the disease. Results Toxic exposure to crystalline silica and pesticides is underestimated by patients. Non-biased job-exposure matrices retrieved more exposed patients than the declarative assessment (10.1% of patients by job-exposure matrices vs 6.3% by declaration for crystalline silica and 25.9% vs 12.2% for pesticides). Patients overestimate their solvent exposure (7.9% for chlorinated solvents and 4.8% for trichlorethylene assessed by job-exposure matrices and 24.4% declarative exposure to solvents at large). Clinical form evaluation revealed a non-significant trend toward an increased risk of crystalline silica occupational exposure in the pulmonary fibrotic group of SSc patients [odds ratio (OR) 3.12 (95% CI 0.80, 12.15)]. We also observed a non-significant trend toward an elevated OR ([2.89 (95% CI 0.93, 8.95)] for chlorinated solvent occupational exposure and the vascular phenotype of SSc. Of note, pesticide occupational exposure evaluation represents one of the largest to date in SSc patients. Conclusion This study emphasizes that many exposed SSc patients are unaware of their occupational exposure. Job-exposure matrices allow better exposure screening for SSc secondary prevention and occupational exposure compensation. Clinical trial registration clinicaltrials.gov (https://www.clinicaltrials.gov), NCT03543956 [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study aimed to develop and evaluate a job-exposure matrix (JEM) specific to healthcare workers, JEM Soignances, based on self-reported data. METHODS: The JEM was constructed using data from healthcare workers within the CONSTANCES cohort (N=12 489). Job titles and sectors of activity (eg, hospital activities) defined occupational groups. We assessed 24 exposures covering organizational, psychosocial, physical, chemical and biological factors. Several methods (group-based frequency, CART, random forest, extreme gradient boosting machine) were applied using a 70% training sample. Performance was evaluated on the remaining 30% using area under the ROC curve (AUC) and Cohen’s Kappa (κ). Two alternative JEM were proposed using only job titles or adding healthcare establishment size and type (public/private) to define occupational groups. RESULTS: All methods offered similar discriminatory power (AUC). We selected the group-based frequency method as it was the most understandable and easiest to implement. Of the 24 included exposures, 15 demonstrated satisfactory performance, with nine showing good discriminatory power and fair-to-moderate agreement, such as physical effort at work (AUC=0.861, κ=0.556), ionizing radiation exposure (AUC=0.865, κ=0.457), carrying heavy loads (AUC=0.840, κ=0.402), shift work (AUC=0.807, κ=0.383), and formaldehyde exposure (AUC=0.847, κ=0.289). The remaining nine exposures mainly showed poor-to-moderate discriminatory power and poor agreement. Compared to JEM Soignances, the job title-only JEM performed poorly, while the one incorporating healthcare establishment size and type showed similar results. CONCLUSIONS: JEM Soignances provides good internal performance and validity. Future research will assess its external validity by comparing it with existing JEM and examining its predictive validity regarding known associations between exposures and health outcomes (eg, long working hours and strokes).

Introduction The problem of transcoding is recurrent when researchers wish to link occupational data from cohorts to Job-Exposure Matrices (JEMs) which were not set up in the same classifications. The Occupational Asthma-specific JEM (OAsJEM) is a JEM developed for assessing exposure to agents known at risk for asthma for jobs coded with ISCO88 occupation classification. To apply the OAsJEM in the CONSTANCES cohort, in which jobs and industries were coded with French PCS2003 and NAF2008 classifications respectively, we developed a crosswalk to convert jobs from PCS2003 into ISCO88 classification. Methods This work was carried out by 2 skilled coders and 1 novice coder who have worked independently by using different tools and transcoding strategies defined a priori. Consensus meetings were organized with skilled coders to define the final crosswalk. This work was elaborated in 2 steps: (i) for 38 ISCO88 codes classified as potentially exposed to cleaning and disinfection products by the OAsJEM, and (ii) for all jobs from the ISCO88 classification. A comparison between the 3 initial coder's crosswalk proposals and the final crosswalk was made for the 38 ISCO codes in step (i). Results The final crosswalk provided 998 matches between the 482 4-digit PCS2003 codes, 308 4-digit ISCO88 codes, and 31 3-digit ISCO88 codes. Information regarding the NAF2008 industry classification was also used in some cases to improve the final crosswalk. For the selected 38 ISCO88 codes, the final crosswalk provided 110 combinations, but the number of proposed ISCO88–PCS2003 couples by each of the 3 coders varied greatly from 68 to 153. In addition, an important variability between the 3 coders were observed among the number of common combinations between the initial coder's proposals and the final crosswalk (from 47% to 78%). Discussion We have developed a crosswalk specifically for an application of the OAsJEM in population-based surveys using the PCS2003 occupation classification. The development of this crosswalk is of great interest for the use of OAsJEM on the data of the CONSTANCES cohort and on any other survey with occupational data coded according to the French classifications. This OAsJEM crosswalk could be used by other teams to evaluate occupational exposures known to be at risk of asthma from occupational calendars coded with French classifications. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The quantitative job-exposure matrix SYN-JEM consists of various dimensions: job-specific estimates, region-specific estimates, and prior expert ratings of jobs by the semi-quantitative DOM-JEM. We analyzed the effect of different JEM dimensions on the exposure–response relationships between occupational silica exposure and lung cancer risk to investigate how these variations influence estimates of exposure by a quantitative JEM and associated health endpoints. METHODS: Using SYN-JEM, and alternative SYN-JEM specifications with varying dimensions included, cumulative silica exposure estimates were assigned to 16 901 lung cancer cases and 20 965 controls pooled from 14 international community-based case-control studies. Exposure–response relationships based on SYN-JEM and alternative SYN-JEM specifications were analyzed using regression analyses (by quartiles and log-transformed continuous silica exposure) and generalized additive models (GAM), adjusted for age, sex, study, cigarette pack-years, time since quitting smoking, and ever employment in occupations with established lung cancer risk. RESULTS: SYN-JEM and alternative specifications generated overall elevated and similar lung cancer odds ratios ranging from 1.13 (1st quartile) to 1.50 (4th quartile). In the categorical and log-linear analyses SYN-JEM with all dimensions included yielded the best model fit, and exclusion of job-specific estimates from SYN-JEM yielded the poorest model fit. Additionally, GAM showed the poorest model fit when excluding job-specific estimates. CONCLUSION: The established exposure–response relationship between occupational silica exposure and lung cancer was marginally influenced by varying the dimensions of SYN-JEM. Optimized modelling of exposure–response relationships will be obtained when incorporating all relevant dimensions, namely prior rating, job, time, and region. Quantitative job-specific estimates appeared to be the most prominent dimension for this general population JEM.

Objectives Industry- and occupation-based carcinogen exposure matrices play a pivotal role in preventing occupational cancer. While the Korean CARcinogen EXposure (K-CAREX) has been developed in recent years to assess exposure prevalence and intensity by industry, the feasibility of constructing an occupation-based exposure matrix remains unexplored. Hence, the objective of this study is to explore the potential of combining the nationwide work environment measurement database (WEMD) and the special health examination database (SHED) to develop a comprehensive occupation-based exposure matrix. Methods The WEMD provides information on airborne lead measurements, including industry codes, but it does not include data related to occupations. In contrast, the SHED contains information on both occupation and blood lead levels. By integrating these 2 databases, we attempted to assess airborne lead exposure levels by occupation. Additionally, we performed a rank correlation analysis to compare the airborne exposure levels with corresponding blood lead levels according to occupation. Results A total of 35 425 workers who both wore air samplers for lead and underwent special health examinations for lead were extracted between 2019 and 2021. An occupation-based exposure matrix was developed to evaluate the intensity of lead exposure across a range of occupations, encompassing 51 minor occupations and 70-unit occupations. Rank correlation analyses showed strong positive correlations between airborne lead and blood lead measurements according to occupation. Conclusions Our study findings suggest that combining 2 nationwide surveillance databases can be an effective approach for creating an occupation-based exposure matrix. However, our results also highlight several limitations that need to be addressed in future studies to improve the accuracy and reliability of such matrices. [ABSTRACT FROM AUTHOR]

Background Job-exposure matrices (JEMs) are often used for exposure assessment in occupational exposure and epidemiology studies. However, general population JEMs are difficult to find and access for workers in the United States of America. Objective We aimed to use publicly available information to develop a JEM-like exposure assessment method to determine exposure to a wide range of occupational agents in a wide range of occupations for US general population studies. Methods We used information from the US Department of Labor's Occupational Information Network database (O*NET) for 19,636 job tasks and 974 civilian occupations. We used automated keyword searches to identify 1,804 job tasks that involved exposure to 50 occupational agents. We had 2 reviewers determine whether each identified job task actually involved exposure to the 50 occupational agents. We had a third reviewer, a certified industrial hygienist, assess any job task and exposure for which the first 2 reviewers disagreed. For each U.S. Census 2010 occupation code, we used this information to derive 3 exposure variables for each occupational agent: ever exposure, number of job tasks of exposure, and frequency of exposure. Results Our keyword searches identified a median of 10 (interquartile range [IQR]: 43.75) job tasks for each occupational agent, and the maximum was 308. We determined job tasks actually involved exposure to 45 occupational agents, including solvents, air pollution, pesticides, radiation, metals, etc. We derived the 3 exposure variables for these 45 occupational agents for 516 U.S. Census 2010 occupation codes. The median percentage for ever exposure to individual occupational agents was 1.16% (IQR: 1.74%), and the maximum was 11.43%. Conclusions Our JEM-like exposure assessment method based on O*NET information can be used to determine exposure to a wide range of occupational agents in a wide range of occupations for the US general population. [ABSTRACT FROM AUTHOR]

Background: Worldwide, lung cancer is the second leading cause of cancer death in women. The present study explored associations between occupational exposures that are prevalent among women, and lung cancer. Methods: Data from 10 case–control studies of lung cancer from Europe, Canada, and New Zealand conducted between 1988 and 2008 were combined. Lifetime occupational history and information on nonoccupational factors including smoking were available for 3040 incident lung cancer cases and 4187 controls. We linked each reported job to the Canadian Job‐Exposure Matrix (CANJEM), which provided estimates of probability, intensity, and frequency of exposure to each selected agent in each job. For this analysis, we selected 15 agents (cleaning agents, biocides, cotton dust, synthetic fibers, formaldehyde, cooking fumes, organic solvents, cellulose, polycyclic aromatic hydrocarbons from petroleum, ammonia, metallic dust, alkanes C18+, iron compounds, isopropanol, and calcium carbonate) that had lifetime exposure prevalence of at least 5% in the combined study population. For each agent, we estimated lung cancer risk in each study center for ever‐exposure, by duration of exposure, and by cumulative exposure, using separate logistic regression models adjusted for smoking and other covariates. We then estimated the meta‐odds ratios using random‐effects meta‐analysis. Results and Conclusions: None of the agents assessed showed consistent and compelling associations with lung cancer among women. The following agents showed elevated odds ratio in some analyses: metallic dust, iron compounds, isopropanol, and organic solvents. Future research into occupational lung cancer risk factors among women should prioritize these agents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate the association between Parkinson’s disease (PD) and occupational exposure to organic solvents generally and chlorinated hydrocarbons (CHC) in particular. METHODS: We assembled a Finland-wide case–control study for birth years 1930–1950 by identifying incident PD cases from the register of Reimbursement of Medical Costs and drawing two controls per case using incidence density sampling from the Population Information System, matched on sex, birth year, and residency in Finland in 1980–2014. Occupation and socioeconomic status (SES) were identified from national censuses. We assessed cumulative occupational exposures via FINJEM job-exposure matrix. Smoking was based on occupation-specific prevalence by sex from national surveys. We estimated confounder-adjusted PD incidence rate ratios (IRR) via logistic regression and evaluated their sensitivity to errors in FINJEM through probabilistic bias analysis (PBA). RESULTS: Among ever-employed, we identified 17 187 cases (16.0% potentially exposed to CHC) and 35 738 matched controls. Cases were more likely to not smoke and belong to higher SES. Cumulative exposure (CE) to CHC (per 100 ppm-years, 5-year lag) was associated with adjusted IRR 1.235 (95% confidence interval 0.986–1.547), with stronger associations among women and among persons who had more census records. Sensitivity analyses did not reveal notable associations, but stronger effects were seen in the younger birth cohort (1940–1950). PBA produced notably weaker associations, yielding a median IRR 1.097 (95% simulation interval 0.920–1.291) for CHC. CONCLUSION: Our findings imply that PD is unlikely to be related to typical occupational solvent exposure in Finland, but excess risk cannot be ruled out in some highly exposed occupations.

Abstract Background Endometrial cancer is the most common gynaecological tumour in developed countries and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms. Objective This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain. Methods The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp). Results Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88, OR = 4.40; 95% CI = 1.65–13.33, and OR = 5.25; 95% CI = 1.84–17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59–12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55–2.67). Conclusions Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour.

OBJECTIVES: Crystalline silica is found in many construction materials. Although it is one of the oldest known occupational exposures, new exposure contexts have emerged in recent years. In 2021, France classified work involving exposure to respirable crystalline silica (ie, silica dust) generated by a work process as carcinogenic. In order to assess exposure in the French workforce between 1947 and 2020, we developed a silica job-exposure matrix (JEM) for the Matgéné program. METHOD: The JEM was linked with occupational data from different population censuses (1982, 1990, 1999, 2007 and 2017). The proportions and numbers of workers exposed to silica dust in France at these various census time points were estimated and described by sex and industry for 2017. RESULTS: After decreasing between 1982 and 1999, the proportion of workers exposed to silica dust remained stable at 4%, representing 975 000 workers in 2017. Exposed workers were mostly men (93%), and most worked in the construction industry (64%). This was also the industry where the majority of workers were exposed to a level above the French 8-hour time weighted average occupational exposure limit (TWA-OEL). CONCLUSION: A large number of workers in France were still exposed (some highly) to silica dust in 2017 so this agent still poses an occupational health concern. The results of this study provide key information about the continued surveillance of the evolution of exposure to silica dust. In a few years, it will be possible to quantify the impact of the 2021 regulation in terms of proportions and number of workers exposed to silica dust.

OBJECTIVES: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. METHODS: A French nationwide case–control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. RESULTS: Occupational exposure to at least one solvent during the year of their son’s birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68–1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55–3.61), methylene chloride (OR 1.13, 95% CI 0.54–2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80–1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79–2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65–1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11–6.76). CONCLUSION: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

Purpose: To examine the association of exposure to Occupational Physical Activity (OPA) with all-cause mortality and incidence of cardiovascular diseases (CVD). Methods: The study population was composed of three Italian cohorts: a national cohort of employees participating in the National Health Survey 2005, followed-up until 2014 (ILS 2005), and two urban cohorts of employees resident in Turin at 2001 and 2011 censuses (TLS 2001 and TLS 2011, respectively), both followed-up until 2018. Follow-up was conducted through individual record-linkage with death registries and hospital admissions archives. Exposure to OPA was assigned through an Italian job-exposure matrix (JEM). Relative Risks of both CVD incidence and overall mortality associated with OPA quartiles (IRR) were estimated using Poisson regression models adjusted for socio-demographics and health, and in the national cohort, also for leisure time physical activity, BMI, smoking, diabetes, and hypertension. Results: Compared to the lowest quartile, the highest OPA quartile was associated in both genders with significantly increased mortality in TLS 2001 (IRR = 1.11 among men, IRR = 1.20 among women) and in TLS 2011 (IRR = 1.27 among men and IRR = 1.73 among women), whereas in the ILS 2005 cohort no association was found. Among women, high OPA was also associated with CVD risk in TLS 2001 and 2011 (IRR = 1.39 and IRR = 1.16 for the highest quartile, respectively), while in the ILS cohort in both genders only the third quartile showed a significantly higher risk. Conclusion: Our results indicate that OPA does not have a beneficial effect on CVD and mortality, but rather suggest that it may produce deleterious health effects. [ABSTRACT FROM AUTHOR]

Objective: Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD). Methods: A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45–64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP. Results: Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32–1.46) and for those with high physical workload 1.48 (1.39–1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures. Conclusion: Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP). [ABSTRACT FROM AUTHOR]

The article investigates the association between Parkinson's disease (PD) and occupational exposure to organic solvents, particularly chlorinated hydrocarbons (CHC), in Finland. The study, conducted through a nationwide case-control approach, analyzes cumulative occupational exposures using a job-exposure matrix and explores potential biases in exposure measurement through probabilistic bias analysis (PBA).

Background: Endometrial cancer is the most common gynaecological tumour in developed countries and disease burden is expected to increase over the years. Identifying modifiable risk factors may help developing strategies to reduce the expected increasing incidence of these neoplasms. Objective: This study evaluates the association between occupational exposure to pesticides and endometrial cancer using data from a recent case-control study in Spain. Methods: The analyses included data from 174 consecutive incident endometrial cancer cases and 216 hospital controls frequency-matched by age. Data were collected through structured epidemiological questionnaires and exposure to pesticides was assessed using a Spanish job-exposure matrix (MatEmESp). Results: Overall, 12% of controls and 18% of cases were occupationally exposed to pesticides. We observed a positive association between occupational exposure to pesticides and endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88 compared to non-exposed). In general, exposures that occurred farther in the past were significantly associated with endometrial cancer. Exposure to insecticides, fungicides and herbicides were positively associated with endometrial cancer (OR = 2.08; 95% CI = 1.13–3.88, OR = 4.40; 95% CI = 1.65–13.33, and OR = 5.25; 95% CI = 1.84–17.67, respectively). The agricultural, poultry and livestock activities scenario was associated with endometrial cancer (OR = 4.16; 95% CI = 1.59–12.32), while the cleaning exposure scenario was not (OR = 1.22; 95% CI = 0.55–2.67). Conclusions: Assessment of occupational exposure to pesticides assessed using a Spanish job-exposure matrix revealed a positive association with endometrial cancer. The elucidation of the role of pesticide compounds on endometrial cancer should shed a light on the aetiology of this tumour. [ABSTRACT FROM AUTHOR]

Objectives Workers at sewage treatment plants are exposed to a complex mixture of toxins, including hydrogen sulphide (H2S). An issue of concern among sewage workers, is possible negative nervous system effects from low-level H 2 S exposure. Empirical neuropsychological evidence indicates both that low-dose exposure to H2S exposure affects the nervous system, and the contrary, that such exposure may facilitate nervous system function, since H2S is an endogenously produced central nervous system (CNS) gasotransmitter. The aim of this study is to describe a possible association between the H2S component of the total exposure and long-term effects on neuropsychological motor function among wastewater workers. Methods Workers (N = 138) treating wastewater in 6 sewage-treatment plants, or in the sewer net system participated in a cross-sectional study. H2S exposure was expressed in a dichotomous exposure variable defining currently H2S-exposed (N = 112) and unexposed referent workers (N = 26), and a variable defining a job-exposure matrix for long-term total typical workplace H2S exposure. The participants went through neuropsychological tests for hand coordination, reaction time (SRT), and balance, and completed questionnaires. Pearson chi-square test or independent samples t -test was used when comparing the currently H2S-exposed workers with the unexposed control group. Multiple linear regression was used to assess associations between the independent variables age, smoking and exposure variables, and the neuropsychological tests. Results The analyses indicate increased SRT in the currently H2S-exposed group compared to controls (mean [SD] = 225.8 [29.9] versus 210.7 [26.3] ms, P = 0.019), and an association between increased SRT and current H2S-exposure in the total study sample (β = 14.7, P = 0.026, R 2 = 0.06, P = 0.050). Blindfolded balance testing indicates a nonsignificant trend in the total study sample , of reduced balance in the highest versus lowest H2S total long-term exposure-index group (Sway area [mean {SD}, mm2: 702 [410] versus 581 [278]), and a significant association between total long-term H2S exposure and reduced balance among smokers (Sway area, mm2 [β = 38.7, P = 0.039], mean sway, mm [β = 0.3, P = 0.015]). Conclusion The observed trends and associations may be due to exposure peaks in certain work operations and pinpoint the importance of minimizing and avoiding exposure peaks, also when H2S time-weighted average measurements do not exceed an occupational exposure limit of 5 ppm. [ABSTRACT FROM AUTHOR]

The article presents the discussion on crystalline silica is found in many construction materials. Topics include exposure to respirable crystalline silica (ie, silica dust) generated by a work process as carcinogenic; and possible to quantify the impact of the 2021 regulation in terms of proportions and number of workers exposed to silica dust.

Researchers have long documented a significant association between exposure to unfavorable working conditions and poorer occupational health and safety. However, measures of occupational exposures are often lacking from national and international surveys. Drawing on research on job-exposures matrices (JEMs) and exploiting the Italian O*NET, we construct a new indicator of exposure to ergonomic unfavorable conditions at work (Ergo-Index) and we test its predictive power on the incidence of work-related musculoskeletal disorders. Exploiting 5-years of administrative archives of the Italian National Workers Compensation Institute and running a set of negative binomial regression models, we find a very strong association between the Ergo-Index and the incidence of work-related musculoskeletal disorders (WRMSD). Compared to the least exposed category (Ergo-Index < p25), the risk of WRMSD was 60–70 times higher in the highest exposure group (Ergo-Index > p75) for notified WRMSD, and almost 250 times higher for compensated WRMSD. Hence, the Ergo-Index strongly predicts the occurrence of occupational musculoskeletal disorders and could be used to assign work exposures in studies where occupation is available and for priority setting of ergonomic hazards control. [ABSTRACT FROM AUTHOR]

Objective: To elucidate whether occupational noise exposure increases the mortality from ischemic heart disease (IHD) and stroke, and if exposure to paper dust modified the risks. Methods: We studied 6686 workers from soft paper mills, with occupational noise exposure, < 85 dBA, 85–90 dBA and > 90 dBA, and high (> 5 mg/m3) exposure to paper dust. Person-years 1960–2019 were stratified according to gender, age, and calendar-year. Expected numbers of deaths were calculated using the Swedish population as the reference and standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were assessed. Results: SMR for IHD was 1.12 (95% CI 0.88–1.41) for noise < 85 dBA, 1.18 (95% CI 0.90–1.55) for 85–90 dBA, and 1.27 (95% CI 1.10–1.47) among workers exposed > 90 dBA. Joint exposure to high noise exposure and high exposure to paper dust resulted in slightly higher IHD mortality (SMR 1.39, 95% CI 1.15–1.67). SMR for ischemic stroke was 0.90 (95% CI 0.37–2.15) for noise < 85 dBA, 1.08 (95% CI 0.45–2.59) for 85–90 dBA, and 1.48 (95% CI 0.99–2.00) among workers exposed > 90 dBA. High noise exposure and high exposure to paper dust resulted in higher ischemic stroke mortality (SMR 1.83, 95% CI 1.12–2.98). Conclusion: Noise levels > 90 dBA was associated with increased IHD mortality. Combined exposures of noise and paper dust may further increase the risks. Our results do not provide support for a causal relationship for ischemic stroke. Residual confounding from smoking has to be considered. Workers need to be protected from occupational noise levels exceeding 90 dBA. [ABSTRACT FROM AUTHOR]

The article presents the discussion on etiology of testicular germ cell tumors (TGCT) suspected to be related to prenatal environmental risk factors. Topics include examining the association between parental occupational exposure to solvents and TGCT risk among their offspring; and impact of the fetal environment is also supported by large geographical variation in incidence and the evolution of TGCT incidence among migrant populations.

ObjectiveTo examine associations with occupational livestock or other animal dust exposure and offspring cancer risk.MethodsIn this population-based case-control study of Danish children aged

Objective Many occupations and industries use wood as a raw material and wood dust is a well-known carcinogen. This study presents trends in occupational exposure to wood dust for all workers (employees and self-employed workers) in France between 1982 and 2017 and focuses on the exposed workers in 2017. Methods Exposures to this carcinogen were assessed using the Matgéné job-exposure matrix. Trends in the prevalence and proportion of exposure over the study period were estimated by linking the matrix with population data from the 1982, 1990, 1999, 2007, and 2017 censuses and are described for selected industry groups. Results The number of exposed workers to wood dust has decreased significantly over the last 40 years, from 466,900 potentially exposed workers in 1982 to 305,000 workers in 2017. The proportion of exposed workers has also decreased over time, although not uniformly across industries. Increases in the proportion of exposed workers are observed in certain industries, such as "Sawmilling and logging" (from 61.2% to 73.6% over the period for men) and "Finishing of sale premises" (from 3.3% to 6.2% for women). Conclusion This article is the first to describe occupational exposure to wood dust in France for all workers and to follow its evolution over the last 40 years. Occupations and industries still at risk in 2017 are also described with the aim of helping to improve prevention policies. [ABSTRACT FROM AUTHOR]

Purpose: The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor–gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking. Methods: This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders. Results: Mineral dust had the most consistent association with change in FEV1, including ever/never (– 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity (– 91.4 ml) among all participants, and limited to cigarette smokers with results of – 104.6 ml ever/never exposed, – 170.3 ml high duration, and – 172.4 ml high cumulative. Conclusion: The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results. [ABSTRACT FROM AUTHOR]

Background: A preliminary job-exposure matrix (JEM) for radiofrequency electromagnetic fields (RF-EMF) was created based on self-reported occupational information from a multi-country population-based study of approximately 10,000 participants combined with available measurement data compiled in a source-exposure matrix (spot measurements). In order to address the limited personal occupational RF-EMF measurement data available in the literature, we performed a measurement campaign among workers in various occupations in Spain and France. Methods: Personal full-shift measurements were conducted using RadMan 2XT™ (Narda) devices. A worker diary was used to capture information on occupational and background sources of RF exposure during the shift. Inclusion of occupations to be measured was initially based on exposure prevalence and level information in the preliminary JEM and expert judgment. Results: Personal full-shift measurements were conducted among 333 workers representing 46 ISCO88 occupations. Exposure to electric (E) and magnetic (H) fields was infrequent with >99% of measurements below the detection limit of the device (≥1% of the 1998 ICNIRP standards). A total of 50.2% and 77.2% of workers were ever exposed to E and H fields respectively (having at least one recorded 1-second measurement above the detection limit). Workers in elementary occupations, technicians and associate professionals, plant and machine operators and assemblers had somewhat greater numbers of measurements above the detection limit, higher maximum values and longer exposure durations. A small proportion of measurements were ≥100% of the standards, though these exceedances were brief (generally a few seconds in duration). Female workers and workers reporting use of any RF-EMF emitting source were more likely to have a measured exposure to E and H fields. Conclusion: We conducted personal RF-EMF measurements among workers in various occupations in Spain and France. Overall, RF-EMF exposure ≥1 % ICNIRP was infrequent, despite some intermittent exposures ≥100% observed among workers in some occupations.

This study found no association between exposure to hand-arm vibrations (HAV) and myocardial infarction. Data was gathered from the Swedish National Cohort on Work and Health and consists of all individuals born in Sweden from 1930 to 1990, with demographic, occupational, and MI data available between 1968 and 2017. All workers in Sweden with an occupational code between 1985 and 2013 were matched to the job-exposure matrix on occupational exposures. The model was adjusted for demographic data and other occupational exposures. The hazard ratio with a 95% confidence interval was 1.01 (0.92-1.11) for those exposed above the daily equivalent HAV level of 5 m/s². [ABSTRACT FROM AUTHOR]

This paper studies the possible combined effect of occupational exposure and chronic airway disease to all-cause and respiratory related mortality in a longitudinal study setting. The results suggest that occupational airborne exposure increases mortality and is even more harmful for those with asthma and COPD coexistence. Objectives: Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort. Methods: We divided the participants based on the answers to asthma and chronic obstructive pulmonary disease (COPD) diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure. Results: High exposure had a hazards ratio (HR) of 1.34 (1.11–1.62) and asthma and COPD coexistence of 1.58 (1.10–2.27). The combined effects of intermediate exposure and coexistence had an HR of 2.20 (1.18–4.09), high exposure with coexistence of 1.94 (1.10–3.42) for overall mortality, and sub-HR for respiratory-related mortality of 3.21 (1.87–5.50). Conclusions: High occupational exposure increased overall but not respiratory-related mortality hazards, while coexisting asthma and COPD overall and respiratory-related hazards of mortality. [ABSTRACT FROM AUTHOR]

Objective: The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM). Methods: The study population was composed of 24,604 persons of 40–69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders. Results: In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20–30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15–20% controlling for other significant covariates. Conclusion: Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers' exposure to ergonomic factors. [ABSTRACT FROM AUTHOR]

Background: Working in close contacts with coworkers or the general public may be associated with transmission of invasive pneumococcal disease (IPD). We investigated whether crowded workplaces, sharing surfaces, and exposure to infections were factors associated with IPD. Methods: We studied 3,968 cases of IPD, and selected six controls for each case from the Swedish population registry with each control being assigned the index date of their corresponding case. We linked job histories to job‐exposure matrices to assess different transmission dimensions of pneumococci, as well as occupational exposure to fumes. We used adjusted conditional logistic analyses to estimate the odds ratios (ORs) for IPD with 95% confidence intervals (95% CI). Results: ORs for IPD for the different transmission dimensions were increased moderately but were statistically significant. Compared to home‐working or working alone, the highest odds was for Working mostly outside, or partly inside (OR 1.19, 95% CI 1.04−1.38). Estimates were higher in men for all dimensions, compared to women. The odds for IPD for Working mostly outside, or partly inside were 1.33 (95% CI 1.13−1.56) and 0.79 (95% CI 0.55−1.14) for men and women, respectively. Higher odds were seen for all transmission dimensions among those exposed to fumes, although CIs included unity. Contact with ill or infected patients did not increase the odds for IPD. Conclusion: IPD was associated with working in close contact with coworkers or the general public, and with outside work, especially for men. Contact with infected patients or persons was not associated with IPD. [ABSTRACT FROM AUTHOR]

Background: Studies among workers with a wide range of exposure to perfluoroalkyl substances inform risk assessments. Perfluorooctane sulfonate (PFOS), a ubiquitous environmental contaminant, was recently examined in relation to mortality and cancer incidence in an occupationally exposed population by Alexander et al. in 2024. In that study, cumulative occupational exposure (mg/m3 PFOS-equivalents in air) was reconstructed using a job-exposure matrix and individual work history. While the exposure reconstruction had good face validity, an assessment of its performance in relation to serum PFOS levels would allow improved interpretation of the occupational epidemiology findings., Objective: The objective of this study was to assess the validity of the exposure reconstruction used by Alexander et al. (2024)., Methods: A previous study by Olsen et al. (2003) measured serum PFOS levels in 1998 for 260 workers and because these workers were included in the epidemiologic study by Alexander et al. (2024), the study reported herein compared serum PFOS levels to those predicted using a simple compartmental pharmacokinetic model., Results: The Pearson correlation coefficient between the observed and pharmacokinetic model-predicted serum PFOS concentration was 0.80 (95% confidence interval, 0.75 to 0.84). The median ratio of predicted to observed serum concentrations was 12 (i.e. actual exposure was significantly less than predicted). The predicted serum PFOS concentrations were not sensitive to the parameters used in the pharmacokinetic model other than exposure concentration or absorption., Conclusions: The model did not predict absolute exposure well, probably because of personal protective equipment use not being accounted for and absorption of PFOS or precursors being lower than modeled. On the other hand, the model did a reasonably good job of ranking the workers' exposure, thus classification of workers according to relative amount of cumulative PFOS-equivalents was reasonably accurate in the study by Alexander et al. (2024) when validated using the measured serum PFOS data., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Background: Comparison between cross‐national job‐exposure matrices (JEMs) may provide indications of their reliability, particularly if created using the same items. This study evaluated concordance between two JEMs created from United States (US) and Italian O*NET data, using job codes linked through international job codes. Methods: Twenty‐one physical exposures were obtained from the US and Italian O*NET databases. Italian O*NET items were direct translations of US O*NET items. Six hundred and eighty‐four US and 586 Italian job codes were linked via crosswalks to 281 ISCO‐08 job codes. A sensitivity study also assessed concordance on 258 jobs matched one‐to‐one across the two national job classifications. Concordance of US and Italian O*NET exposures was estimated by intraclass correlation coefficients (ICC) in multilevel models adjusted and not adjusted for country. Results: ICCs showed moderate to poor agreement for all physical exposures in jobs linked through ISCO‐08 codes. There was good to moderate agreement for 14 out of 21 exposures in models with one‐to‐one matched jobs between countries; greater agreement was found in all models adjusted for country. Exposure to whole‐body vibration, time standing, and working outdoor exposed to weather showed the highest agreement. Conclusions: These results showed moderate to good agreement for most physical exposures across the two JEMs when US and Italian jobs were matched one‐to‐one and the analysis was adjusted for country. Job code assignments through crosswalks and differences in exposure levels between countries might greatly influence the observed cross‐country agreement. Future multinational epidemiological studies should consider the quality of the cross‐national job matching, and potential cross‐national differences in exposure levels. [ABSTRACT FROM AUTHOR]

Parental occupational exposures around conception (father) or during pregnancy (mother) have been hypothesized as potential predisposing factors for childhood leukaemia. We investigated parental exposure to several known occupational carcinogens and childhood leukaemia risk. We conducted a pooled analysis using case-control data from four European countries (3362 childhood leukemia cases and 6268 controls). Parental occupational exposures to polycyclic aromatic hydrocarbons (PAH), diesel engine exhaust (DEE), chromium, nickel, crystalline silica, and asbestos were assessed by a general population job-exposure matrix. We estimated odd ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models for all childhood leukaemia combined, by leukaemia type (ALL and AML) and by ALL subtype (B-lineage and T-lineage). We found an association between high paternal occupational exposure to crystalline silica and childhood ALL (OR 2.20, CI 1.60–3.01) with increasing trend from no exposure to high exposure (P =

Objective: We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA). Methods: This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: "moderate", "rather poor" and "very poor" indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27. Results: MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00–8.15, women: AOR: 3.25 95% CI 1.81–5.83). The SI was non-significant for both sexes. Conclusion: Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces. [ABSTRACT FROM AUTHOR]

Objectives The Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET) was set up to enable optimization of the use of industrial and general population cohorts across Europe to advance aetiological research. High-quality harmonized exposure assessment is crucial to derive comparable results and to enable pooled analyses. To facilitate a harmonized research strategy, a concerted effort is needed to catalogue available occupational exposure information. We here aim to provide a first comprehensive overview of exposure assessment tools that could be used for occupational epidemiological studies. Methods An online inventory was set up to collect meta-data on exposure assessment tools. Occupational health researchers were invited via newsletters, editorials, and individual e-mails to provide details of job-exposure matrices (JEMs), exposure databases, and occupational coding systems and their associated crosswalks to translate codes between different systems, with a focus on Europe. Results Meta-data on 36 general population JEMs, 11 exposure databases, and 29 occupational coding systems from more than 10 countries have been collected up to August 2021. A wide variety of exposures were covered in the JEMs on which data were entered, with dusts and fibres (in 14 JEMs) being the most common types. Fewer JEMs covered organization of work (5) and biological factors (4). Dusts and fibres were also the most common exposures included in the databases (7 out of 11), followed by solvents and pesticides (both in 6 databases). Conclusions This inventory forms the basis for a searchable web-based database of meta-data on existing occupational exposure information, to support researchers in finding the available tools for assessing occupational exposures in their cohorts, and future efforts for harmonization of exposure assessment. This inventory remains open for further additions, to enlarge its coverage and include newly developed tools. [ABSTRACT FROM AUTHOR]

Background: A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. Methods: We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. Results: The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. Conclusions: The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Background: Some largely inconsistent associations between parental occupational dust exposure and childhood cancer have been reported, with maternal exposures inadequately studied. The authors examined whether maternal or paternal occupational exposure to animal, wood, textile, or paper dust around a child's birth was associated with an increased risk of childhood cancer, both overall and by type (leukemias, lymphomas, central nervous system tumors, and other cancers). Methods: In this nationwide, register‐based, case‐control study, children who were diagnosed with cancer from 1960 to 2015 were compared with up to 25 matched controls regarding maternal and paternal occupational dust exposure (9653 cases in maternal analyses and 12,521 cases in paternal analyses). Exposures were assessed using a job‐exposure matrix and occupational information from census and register data. By using conditional logistic regression models, adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Results: Neither maternal nor paternal occupational exposure to animal, wood, textile, or paper dust was associated with childhood cancer overall, leukemias, or central nervous system tumors. Maternal, but not paternal, wood dust exposure was associated with an increased risk of lymphoma (OR, 1.42; 95% CI, 1.10‐1.84), particularly non‐Hodgkin lymphoma (OR, 2.03; 95% CI, 1.21‐3.40). Conclusions: The current study did not confirm the associations reported previously but is the first to suggest a link between maternal occupational exposure to wood dust around pregnancy and lymphoma in the offspring. This large study does not confirm associations reported previously for leukemia and central nervous system tumors but is the first to suggest a link between maternal occupational exposure to wood dust around pregnancy and lymphoma in the offspring. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The study aims to explore the prospective associations of the psychosocial work exposures of the job strain model with cardiovascular mortality, including mortality for ischemic heart diseases (IHD) and stroke, using various time-varying exposure measures in the French working population of employees. METHODS: The study was based on a cohort of 798 547 men and 697 785 women for which job history data from 1976 to 2002 were linked to mortality data and causes of death from the national death registry. Psychosocial work exposures from the validated job strain model questionnaire were assessed using a job-exposure matrix (JEM). Three time-varying measures of exposure were studied: current, cumulative, and recency-weighted cumulative exposure. Cox proportional hazards models were used to examine the associations between psychosocial work exposures and cardiovascular mortality. RESULTS: Within the 1976–2002 period, there were 19 264 cardiovascular deaths among men and 6181 among women. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with cardiovascular mortality. Most of these associations were also observed for IHD and stroke mortality. The comparison between the different exposure measures suggested that current exposure may be more important than cumulative (or past) exposure. The population fractions of cardiovascular mortality attributable to job strain were 5.64% for men and 6.44% for women. CONCLUSIONS: Psychosocial work exposures of the job strain model may play a role in cardiovascular mortality. The estimated burden of cardiovascular mortality associated with these exposures underlines the need for preventive policies oriented toward the psychosocial work environment.

Objective This study aimed to evaluate sex-specific risks of acute myocardial infarction (AMI) according to lifting and standing/walking at work. METHODS: The study population included 1.15 million Danish wage earners. Annual job codes from 1976 onwards were linked to specific exposures using job-exposure matrices (JEM). Cases of AMI during follow-up 1996–2016 were retrieved from national registers. Incidence rate ratios (IRR) were computed by Poisson regression adjusting for demographic and JEM-assessed lifestyle factors. Models addressed physical activities at work the previous 0–2 years (short-term risk) and cumulative physical activities (long-term risk). RESULTS: During 21.4 million person-years of follow-up, 22 037 AMI occurred in men and 6942 in women. Exposure–response relationships between recent physical activities at work and AMI were not evident. In men, the fully adjusted long-term IRR for the highest of five exposure categories compared to the lowest were 1.09 [95% confidence interval (CI) 1.03–1.15] for lifting and 1.01 (95% CI 0.96–1.07) for standing/walking. In women, the corresponding figures were 1.27 (95% CI 1.15–1.40) and 1.18 (95% CI 1.07–1.30). The latter risk estimate was strongly attenuated, and the trend became insignificant when adjusted for lifting. Findings were only partially supported by sensitivity analyses. CONCLUSION: The study provides limited support to the hypothesis that long-term lifting and standing/walking at work is related to increased risk of AMI. Possible effects of acute physical exertion are not addressed and bias towards the null because of crude exposure assignment cannot be ruled out.

Job-exposure matrices (JEM) are a common method for exposure assessment in occupational epidemiology. The first JEM were described in the early 1980s (1, 2) and have been used in a wide range of settings ever since. A recent review on methods for retrospective exposure assessment in the general population revealed that more than a quarter of the studies on cancer applied a JEM (3). Where JEM originally assigned exposures at a qualitative or semi-quantitative level based on expert ratings, quantitative exposure estimates can also be derived when measurements are used to calibrate these ratings (4-6). A JEM typically consists of job and exposure axes. The major advantage of JEM is that job histories can be translated into specific exposures in a systematic and unbiased way. It is basically a computerized linkage of exposure estimates to job codes, and, as such, JEM represent a highly efficient and reproducible methodology. This way, a standardized exposure assessment within and between studies can be guaranteed, and any misclassification is expected to be non-differential with respect to the health outcome. Once developed, a JEM is relatively easy to apply and less costly than case-by-case expert assessment. These benefits make JEM a particularly useful instrument for exposure assessment in large-scale, general population studies. Such studies (eg, based on register data) permit collection of full occupational histories and enable the study of rare diseases or subtypes. Subjects have typically worked in a wide variety of occupations and industries. Detailed exposure information, which can more easily be collected in industry-based cohorts, is often not available. For register-based cohorts, collected occupational histories are also typically limited to the basic information of job titles and industries. Using JEM, exposures can be assessed for many agents and stressors, based solely on job titles. The DOC*X project is a good example of the use of register data in occupational epidemiology (7). The large number of subjects – the full working population of Denmark for several decades – offers unique opportunities for studying new associations between a variety of exposures and various health outcomes. Individual data from several databases, including health and labour registries, were linked by a personal identifier. For each cohort member, job title and industry have been annually registered and coded (7). Subsequently, the project has been linking a series of JEM to this nationwide cohort to assess several kinds of occupational exposures. A couple of these efforts have been published in this issue of the Scandinavian Journal of Work, Environment and Health to assess the association between physical activities at work and acute myocardial infarction (8) and the risk of work-related hand eczema in relation to wet work (9). It is impossible to go back to all individuals in this cohort to collect detailed information on their occupations: firstly because part of the cohort has died over the years but also due to practical reasons given the large numbers. So, by applying JEM, the Danes make the best use of the information available in their registry data. The ease of using a JEM, by simply assigning exposures based on job titles, also has a flipside. By design, a JEM allocates the same exposure estimates to all workers with the same job title. This aspect represents the main drawback since it is well-recognized that there can be substantial inter-individual variability (10). In other words, a JEM completely dismisses exposure heterogeneity between workers in similar jobs, as has also been acknowledged by the authors of the DOC*X studies (8, 9). Heterogeneity between workers may be larger for some types of exposures than others, particularly when exposures are largely determined by specific tasks. To illustrate, when assessing welding fumes, job title alone does not provide information on different tasks and circumstances that influence the level and frequency of exposure to welding fumes (11). For exposures related to tasks like welding, decreasing or pesticide application – but also exposures such as shift work or certain psychosocial working conditions – exposure assessment based on job title alone may not be sufficient. Thus, researchers need to critically evaluate for each given exposure, if that exposure can be reasonably assessed on the job group level or if further assessment on the workplace, work unit or individual-worker level is needed. A large part of heterogeneity is determined by the workers’ behavior (12). Although this is virtually impossible to take into account in a JEM, some of the exposure heterogeneity may be accounted for by adding more detail, ie, by expanding the number of axes of the JEM. For example, an industry-axis, a time dimension, or region-, sex- and age-specific estimates may help explain part of the exposure heterogeneity. Importantly, this type of information is also typically available in the large studies where the JEM are being applied to. The JEM for wet work used by Lund et al (9) provided sex-specific estimates. A similar effort has been described for mechanical and psychosocial work exposures in Norway (13). In addition to within-job (ie, between-worker) variability, exposures may have large temporal (ie, within-worker) variability. Levels can vary from day-to-day or over the course of the work day, the variability of which is not captured in a JEM. When studying acute health effects, for example, short-term high exposures may be more relevant than the annual average or cumulative levels and a JEM may not provide the appropriate assessment. Many different JEM, in all forms and shapes, have been developed over the last 40 years. Due to the lack of a gold standard, JEM cannot be truly validated. Several studies, however, have described the performance of JEM (14–16). For asbestos, for instance, poor agreement between different JEM has been reported, indicating variable performance (14). Exposure assessment methods can also be evaluated using known associations with health outcomes. Using lung cancer case–control data, comparisons with other methods showed that a JEM for asbestos could outperform self-reported exposure (16) and perform as well as case-by-case expert assessment in a multicenter study (15). Yet, as indicated above, the performance of a JEM will depend on the exposure and effect of interest. Improvement in the use of JEM could be achieved by harmonizing existing JEM. A harmonized JEM, which provides a standardized exposure assessment across regions and time periods, would be highly valuable for pooled analyses. Such large-scale analyses will offer unique opportunities to study exposure–disease associations that have been understudied until now due to lack of statistical power. JEM will be invaluable instruments to such (exploratory) exercises. Derivation of exposure–response relations requires quantification of exposure. Development of more quantitative JEM, as first described for the multinational SYNERGY project on lung cancer (4) and the Shanghai Women’s Health Study (6), may further increase the impact of occupational studies. However, a quantitative JEM will still have the same limitation of assuming homogeneity within jobs and large amounts of (measurement) data are needed to develop a quantitative JEM. Data mining techniques could be explored to make better use. The coding of job titles is another major challenge related to the use of JEM. Manual coding of each individual’s job history in large epidemiological studies is a very time-consuming task. As a result, many of these studies are not used to their full potential for occupational health outcomes. Further improvement could therefore be achieved by systems that automatically translate free text into occupational codes, increasing the efficiency and feasibility of investigating occupational risk factors (using JEM) in large-scale epidemiological studies. Efforts in developing automatic coding in the US have shown agreements with manual coding of around 50% (17, 18). Automated coding systems would not be applicable to most registry data, however, since job information is only available as a code. For pooling these registry data with other data, or for application of another JEM, crosswalks between systems can be the solution. In addition to differences between human coders, crosswalks may also introduce disagreement between codes and actual jobs, possibly leading to further misclassification of exposure. Interestingly, within DOC*X it was shown that errors in job coding had limited effect on the exposure assessment of wood dust, lifting, standing/walking, arm elevation, and noise (19). Previous studies also reported that the effects of disagreements in job coding generally diminish in the exposure assessment stage (12, 20). Specificity is crucial when the prevalence of occupational exposure is low, which is often the case in the general population because possible associations may otherwise be severely underestimated. When exposures are more prevalent, sensitivity becomes more important (12). Since the performance of a JEM is also determined by the between-worker (ie, within job) and between-job variance, the level of detail of the job classification plays an important role. Occupational classification systems have primarily been developed from a social-economic perspective. These systems, either international or national coding schemes, are therefore not necessarily reflecting exposure categories in the best way. Developing new or adjusted coding systems for exposure assessment may help moving the occupational health field forward. Several research initiatives are currently working on such improvements in the use of JEM, including the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET, omeganetcohorts.eu) and the Exposome Project for Health and Occupational Research (EPHOR, www.ephor-project.eu). In conclusion, a JEM can be a very handy tool for exposure assessment in occupational epidemiology, particularly in large-scale studies with limited occupational information. When selecting the most suitable exposure assessment method, however, researchers should always remain critical. Know when a JEM has added value and recognize its limitations. References 1. Hoar SK, Morrison AS, Cole P, Silverman DT. An occupation and exposure linkage system for the study of occupational carcinogenesis. J Occup Med. 1980;22(11):722-6. 2. Pannett B, Coggon D, Acheson ED. A job-exposure matrix for use in population based studies in England and Wales. Br J Ind Med. 1985;42(11):777-83. https://doi.org/10.1136/oem.42.11.777 3. Ge CB, Friesen MC, Kromhout H, Peters S, Rothman N, Lan Q, et al. Use and Reliability of Exposure Assessment Methods in Occupational Case-Control Studies in the General Population: Past, Present, and Future. Ann Work Expo Health. 2018;62(9):1047-63. https://doi.org/10.1093/annweh/wxy080 4. Peters S, Vermeulen R, Portengen L, Olsson A, Kendzia B, Vincent R, et al. Modelling of occupational respirable crystalline silica exposure for quantitative exposure assessment in community-based case-control studies. J Environ Monit. 2011;13(11):3262-8. https://doi.org/10.1039/c1em10628g 5. Peters S, Vermeulen R, Portengen L, Olsson A, Kendzia B, Vincent R, et al. SYN-JEM: A Quantitative Job-Exposure Matrix for Five Lung Carcinogens. Ann Occup Hyg. 2016;60(7):795-811. https://doi.org/10.1093/annhyg/mew034 6. Friesen MC, Coble JB, Lu W, Shu XO, Ji BT, Xue S, et al. Combining a job-exposure matrix with exposure measurements to assess occupational exposure to benzene in a population cohort in shanghai, china. Ann Occup Hyg. 2012;56(1):80-91. https://doi.org/10.1136/oemed-2011-100382.81 7. Flachs EM, Petersen SEB, Kolstad HA, Schlunssen V, Svendsen SW, Hansen J, et al. Cohort Profile: DOC*X: a nationwide Danish occupational cohort with eXposure data - an open research resource. Int J Epidemiol. 2019;48(5):1413-k. https://doi.org/10.1093/ije/dyz110 8. Bonde JPE, Flachs EM, Madsen IE, Petersen SB, Andersen JH, Hansen J, et al. Acute myocardial infarction in relation to physical activities at work: a nationwide follow-up study based on job-exposure matrices. Scand J Work Environ Health. 2019. https://doi.org/10.5271/sjweh.3863 9. Lund T, Petersen SB, Flachs EM, Ebbehoj NE, Bonde JP, Agner T. Risk of work-related hand eczema in relation to wet work exposure. Scand J Work Environ Health. 2020. https://doi.org/10.5271/sjweh.3876 10. Kromhout H, Symanski E, Rappaport SM. A comprehensive evaluation of within- and between-worker components of occupational exposure to chemical agents. Ann Occup Hyg. 1993;37(3):253-70. 11. IARC Working Group. Volume 118: Welding, Indium Tin Oxide, Molybdenum Trioxide.: IARC Monogr Eval Carcinog Risks Hum; 2018. 12. Kromhout H, Vermeulen R. Application of job-exposure matrices in studies of the general population. Some clues to their performance. European Respiratory Review. 2001;11:80-90. 13. Hanvold TN, Sterud T, Kristensen P, Mehlum IS. Mechanical and psychosocial work exposures: the construction and evaluation of a gender-specific job exposure matrix (JEM). Scand J Work Environ Health. 2019;45(3):239-47. https://doi.org/10.5271/sjweh.3774 14. Offermans NS, Vermeulen R, Burdorf A, Peters S, Goldbohm RA, Koeman T, et al. Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in The Netherlands Cohort Study. Occup Environ Med. 2012;69(10):745-51. https://doi.org/10.1136/oemed-2011-100556 15. Peters S, Vermeulen R, Cassidy A, Mannetje A, van Tongeren M, Boffetta P, et al. Comparison of exposure assessment methods for occupational carcinogens in a multi-centre lung cancer case-control study. Occup Environ Med. 2011;68(2):148-53. https://doi.org/10.1136/oem.2010.055608 16. Hardt JS, Vermeulen R, Peters S, Kromhout H, McLaughlin JR, Demers PA. A comparison of exposure assessment approaches: lung cancer and occupational asbestos exposure in a population-based case-control study. Occup Environ Med. 2014;71(4):282-8. https://doi.org/10.1136/oemed-2013-101735 17. Russ DE, Ho KY, Colt JS, Armenti KR, Baris D, Chow WH, et al. Computer-based coding of free-text job descriptions to efficiently identify occupations in epidemiological studies. Occup Environ Med. 2016;73(6):417-24. https://doi.org/10.1136/oemed-2015-103152 18. Burstyn I, Slutsky A, Lee DG, Singer AB, An Y, Michael YL. Beyond crosswalks: reliability of exposure assessment following automated coding of free-text job descriptions for occupational epidemiology. Ann Occup Hyg. 2014;58(4):482-92. 19. Petersen SB, Flachs EM, Svendsen SW, Marott JL, Budtz-Jorgensen E, Hansen J, et al. Influence of errors in job codes on job exposure matrix-based exposure assessment in the register-based occupational cohort DOC*X. Scand J Work Environ Health. 2019. https://doi.org/10.5271/sjweh.3857 20. Koeman T, Offermans NS, Christopher-de Vries Y, Slottje P, Van Den Brandt PA, Goldbohm RA, et al. JEMs and incompatible occupational coding systems: effect of manual and automatic recoding of job codes on exposure assignment. Ann Occup Hyg. 2013;57(1):107-14.

Objectives: Information systems focusing on occupational carcinogen exposure, whether categorized by industry or occupation, play a pivotal role in the prevention of occupational cancers. Recently, the Korean CARcinogen EXposure (K-CAREX) system was developed to assess carcinogen exposure by industry. However, corresponding information categorized by occupation has yet to be developed. This study aimed to develop an occupation-based exposure matrix for occupational carcinogens as an extension of the K-CAREX framework., Methods: The Work Environment Measurement Database (WEMD) and the Special Health Examination Database (SHED) were combined to estimate exposure intensity by occupation. The WEMD supplied exposure levels, whereas the SHED provided occupation information. Additionally, the SHED served as the primary data source for constructing an indicator of exposure prevalence by occupation, utilizing standard occupational classification., Results: A total of 22 carcinogens were selected for evaluating exposure intensity, and 20 carcinogens were selected for assessing exposure prevalence. Exposure intensity and prevalence were assigned to 156 occupational groups based on these carcinogens. For instance, in terms of welding fume exposure, welders were assigned an exposure intensity rating of 3 and exhibited exposure prevalence of 26%., Conclusions: Our findings complement the previously developed K-CAREX, which offered an industry-based exposure matrix. The resultant comprehensive K-CAREX, incorporating both industry- and occupation-based matrices, can be utilized for occupational cancer prevention and epidemiological studies., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: The aim of the study was to examine the associations between heavy physical workload among middle-aged and older workers and disability pension due to any diagnosis, as well as musculoskeletal, psychiatric, cardiovascular or respiratory diagnoses. The population-based design made it possible to examine dose–response and potential gender differences in the associations. Methods: About 1.8 million men and women aged 44–63 years and registered as living in Sweden in 2005 were followed regarding disability pension during 2006–2016, until ages 55–65 years. Mean values of physical workload and job control, estimated through gender-specific job-exposure matrices (JEMs), were assigned to individuals through their occupational titles in 2005. Exposure values were ranked separately for women and men and divided into quintiles. Associations were analyzed with Cox proportional-hazards regression. Results: The analyses showed robust, dose–response associations between physical workload and disability pension with a musculoskeletal diagnosis in both genders: the adjusted hazard ratio and 95% confidence interval for those with the heaviest exposure was 2.58 (2.37–2.81) in women and 3.34 (2.83–3.94) in men. Dose–response associations were also seen in relation to disability pension with a cardiovascular or a respiratory diagnosis, though the hazard ratios were smaller. Physical workload was not associated with disability pension with a psychiatric diagnosis after adjustment for job control. Conclusion: This study of the entire Swedish population of middle-aged and older workers suggests that higher degrees of physical workload may increase the risk of disability pension overall, and specifically with musculoskeletal, cardiovascular or respiratory diagnosis, in both women and men. [ABSTRACT FROM AUTHOR]

Decline in physical performance with age varies among workers. We studied the association between lifetime exposure to carrying heavy loads and limitations in climbing stairs. We used data from the French CONSTANCES study. A biomechanical Job-Exposure Matrix (JEM) was combined with lifetime job histories to build a cumulative exposure score, and compared with reported limitations in climbing stairs using robust Poisson models, stratified by sex and educational level. Of the 26,255 subjects, 618 men and 1,080 women reported difficulties in climbing stairs; this outcome was associated with cumulative exposure to carrying heavy loads: adjusted PR= 2.17 (1.75-2.73) for men, 1.50 (1.30-1.74) for women. The association was primarily seen among less educated subjects. Cumulative work exposure to carrying heavy loads across the working life was associated with physical limitations in climbing stairs among the less educated in both genders. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The aim of this study was to investigate if exposure to chemicals in the workplace was associated with an increased risk of postmenopausal breast cancer. METHODS: The study comprised women born 1923–1950 living in Malmö city, Sweden, 1991–1996, and enrolled for a prospective population cohort study. Occupational exposure to various chemicals was assessed from job-exposure matrices. An extensive set of individual data on hormonal breast cancer risk factors were collected via a baseline questionnaire and used for confounding control. First time diagnoses of invasive breast cancer were identified through the Swedish Cancer Registry until end of follow-up on 31 December 2013. RESULTS: Of 16 084 women, 1011 were diagnosed with breast cancer. Women exposed to chemicals in their occupational environment had a statistically significant increased risk [adjusted hazard ratio (HR_adj) 1.26, 95% confidence interval (CI) 1.02–1.54] of breast cancer, and the risk correlated with duration of exposure. Investigation of risk in association with specific chemicals showed a non-significantly elevated risk after exposure to organic solvents. More than ten years of exposure to diesel exhaust was associated with an increased risk (HR_adj 1.69, 95% CI 1.01–2.82). Occupational chemical exposures account for 2% of the breast cancer cases in this population. CONCLUSIONS: Occupational exposure to chemicals in general was associated with an elevated risk of breast cancer. A slight elevation of risk was seen after exposure to organic solvents. A statistically significant elevation of risk after >10 years of exposure to diesel exhaust was an unexpected finding.

Objective Ultrafine particles (UFPs) are generated from common work processes and have thus existed for a long time. Far more prevalent than engineered nanoparticles, they share common toxicological characteristics with them. However, there is no existing retrospective assessment tool specific to UFPs, for example, for epidemiological purposes. Thus, we aimed to develop a job-exposure matrix dedicated to UFPs. Method Fifty-seven work processes were identified as well as the chemical composition of UFPs emitted, following a literature review and the input of an expert panel. These work processes were associated with occupational codes as defined by the ISCO 1968 classification. The probability and frequency of UFP exposure were assessed for each combination of occupational code and process. Summarized probabilities and frequencies were then calculated for all ISCO occupational codes associated with several processes. Variations in exposure over time or across industrial sectors were accounted for in the assessment of each occupational code. Results In the ISCO classification, 52.8% of the occupational codes (n = 835) assessed were associated with exposure to UFPs, consisting mainly of carbonaceous, metallic, and mineral families (39.5%, 22 and, 15.8%, respectively). Among them, 42.6% involved very probable exposure, and at a high frequency (regularly or continuously). Conclusion These results suggest that occupational exposure to UFPs may be extensive at the workplace and could concern a wide variety of workers. Pending the integration of a third parameter assessing the intensity of UFP exposure, the MatPUF JEM already constitutes a promising and easy-to-use tool to study the possible adverse health effects of UFPs at work. It may also guide prevention policies in the occupational environments concerned, including those involving engineered nanoparticles. [ABSTRACT FROM AUTHOR]