Showing papers in "International Archives of Occupational and Environmental Health in 2007"

Assessment of lipid, hepatic, and thyroid parameters with serum perfluorooctanoate (PFOA) concentrations in fluorochemical production workers

Abstract: Objectives Perfluorooctanoic acid (PFOA) results in peroxisome proliferator mediated effects in rats and mice resulting in hypolipidemia but not in monkeys. Counterintuitive modestly positive associations between PFOA and cholesterol levels in production workers have been inconsistently reported. The purpose of this assessment was to examine this association in male workers who manufactured or used PFOA at three facilities.

Transplacental exposure of neonates to perfluorooctanesulfonate and perfluorooctanoate: a pilot study.

Abstract: Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) can be released of perfluorinated compounds by biotic and/or metabolic decomposition. Due to their ubiquitous occurrence, persistence and bioaccumulative properties they can be found in blood of the general population all over the world. In animal studies PFOS and PFOA provoked cancer and showed developmental toxic potential besides other adverse health effects. On the basis of the comparison of maternal and umbilical cord plasma sample pairs we wanted to examine whether infants are exposed to PFOS and PFOA via their mothers’ blood. We determined PFOS and PFOA in 11 plasma samples of mothers and the 11 corresponding cord plasma samples of neonates. An analytical method based on plasma protein precipitation followed by HPLC with MS/MS-detection was employed. As internal standards we used 1,2,3,4-13C4-PFOS and 1,2-13C2-PFOA. We found PFOS and PFOA in every plasma sample analysed. In maternal plasma samples PFOS concentrations were consistently higher compared to those of the related cord plasma samples (median: 13.0 μg/l vs. 7.3 μg/l). In the case of PFOA we observed only minor differences between PFOA concentrations within the analysed sample pairs (median: 2.6 μg/l vs. 3.4 μg/l for maternal and cord plasma samples, respectively). For both substances a crossing of the placental barrier could be shown. For PFOS we observed a decrease from maternal to cord plasma concentrations by a factor of 0.41–0.80. To the contrary, PFOA crosses the placental barrier obviously unhindered. These findings show that neonates are exposed to PFOS and PFOA via their mothers’ blood. Given the current situation that only little is known about the consequences of PFOS and PFOA exposure in the early state of development of humans and the fact that in animal studies both substances showed developmental toxic effects further research regarding human health effects is indispensable.

Burnout and effort–reward-imbalance in a sample of 949 German teachers

Abstract: Objectives High rates of teachers’ premature retirement initiated a research investigating their occupational burden. The aim of this study was to elaborate on and extend previous investigations exploring (1) teacher burnout and (2) the relationship between teachers’ efforts and their rewards. Methods A sample of 949 German teachers in 10 Gymnasien (grammar schools) and 79 Hauptschulen (secondary modern schools) was investigated applying the Maslach Burnout Inventory (MBI-D) and the Effort Reward Imbalance Inventory (ERI). Results Compared with other studies investigating burnout in employees, we found high rates of burnout symptoms such as emotional exhaustion, depersonalisation, and low personal accomplishment. Male teachers showed significantly lower personal accomplishment and more depersonalization than female teachers. With respect to school types, teachers in Hauptschulen were more often affected by emotional exhaustion and showed more depersonalization. Parttime teachers felt less personal accomplishment than full-time teachers. The ERI cut off was exceeded by 21.6% of all teachers indicating that this subgroup is affected by an imbalance between too much effort and too little reward. With respect to the ERI, significant differences were found for school types, with a higher proportion of Hauptschulen teachers being above this cut off. Conclusions At present, the working situation of teachers appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

Prevalence and prevention of needlestick injuries among health care workers in a German university hospital

Abstract: Health care workers (HCWs) are exposed to bloodborne pathogens, especially hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) through job-related risk factors like needlestick, stab, scratch, cut, or other bloody injuries. Needlestick injuries can be prevented by safer devices. The purpose of this study was to investigate the frequency and causes of needlestick injuries in a German university hospital. Data were obtained by an anonymous, self-reporting questionnaire. We calculated the share of reported needlestick injuries, which could have been prevented by using safety devices. 31.4% (n = 226) of participant HCWs had sustained at least one needlestick injury in the last 12 months. A wide variation in the number of reported needlestick injuries was evident across disciplines, ranging from 46.9% (n = 91/194) among medical staff in surgery and 18.7% (n = 53/283) among HCWs in pediatrics. Of all occupational groups, physicians have the highest risk to experience needlestick injuries (55.1%—n = 129/234). Evaluating the kind of activity under which the needlestick injury occurred, on average 34% (n = 191/561) of all needlestick injuries could have been avoided by the use of safety devices. Taking all medical disciplines and procedures into consideration, safety devices are available for 35.1% (n = 197/561) of needlestick injuries sustained. However, there was a significant difference across various medical disciplines in the share of needlestick injuries which might have been avoidable: Pediatrics (83.7%), gynecology (83.7%), anesthesia (59.3%), dermatology (33.3%), and surgery (11.9%). In our study, only 13.2% (n = 74/561) of needlestick injuries could have been prevented by organizational measures. There is a high rate of needlestick injuries in the daily routine of a hospital. The rate of such injuries depends on the medical discipline. Implementation of safety devices will lead to an improvement in medical staff’s health and safety.

Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists.

Abstract: Objectives: To gain more insight into the prevalence rates of musculoskeletal complaints of neck-shoulder and low back and to determine the relation between physical and psychosocial work-related risk factors and the complaints mentioned in non-specialized nurses, operation room nurses, Intensive Care (IC) nurses and X-ray technologists. Methods: The study population consists of 3,169 employees affiliated to eight university hospitals in the Netherlands. The study was conducted using a cross-sectional survey design. The parameters under study were having or having had (severe) low back or neck-shoulder complaints during the past year. In logistic regression analyses odds ratio’s and CI 95% were estimated for all relevant risk factors for each of the four professional groups. Results: In all groups prevalence rates of musculoskeletal complaints were high: low back 76%, neck-shoulder 60%. Operation room nurses perceived more neck-shoulder complaints (12 months prevalence) than non-specialized nurses and IC nurses perceived less severe low back complaints than non-specialized nurses. Four physical risk factors and one psychosocial factor were associated with low back complaints in all groups. Conclusions: The results of the present study indicate that both low back complaints and neck-shoulder complaints are major health problems in the four professional groups under study. The prevalence rate of neck-shoulder complaints in operation room nurses is higher than in non-specialized nurses and IC nurses, the latter groups having high prevalence rates already. The exposure to risk factors is perceived differently by each of the professional groups. The professional groups under study all are target for preventive interventions; these interventions need to be specified for each of the professional groups.

Occurrence of perfluorinated substances in an adult German population in southern Bavaria

Abstract: Perfluorinated compounds (PFCs) are a large group of chemicals produced for several decades and widely used for many industrial and consumer applications. Because of their global occurrence in different environmental media, their persistence, and their potential to bioaccumulate in organisms they are of toxicological and public concern. In the present study, the internal exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) in 356 human plasma samples collected from an adult population in Germany in 2005 is quantified. We were able to detect the target analytes in all plasma samples and observed a significant correlation between the PFOS and PFOA concentrations. In female participants, the levels of PFOS and PFOA ranged between 2.5–30.7 (median: 10.9 μg/l) and 1.5–16.2 μg/l (median: 4.8 μg/l), respectively. In males we observed concentrations from 2.1 to 55.0 μg/l (median: 13.7 μg/l) for PFOS and from 0.5 to 19.1 μg/l (median: 5.7 μg/l) for PFOA. A significant correlation between both PFOS and PFOA concentrations and gender was observed. We also found increased levels of the PFCs with increasing age of the participants, but this association reached statistical significance among females only. Our data agree well with results of other recent studies in Europe and suggest that the current exposure of the adult German population is lower than the exposure of the US and Canadian population. The sources of human exposure are currently not well understood. Toxicological implications are restricted to animal studies and occupational investigations not adequate for quantitative risk assessment in humans. Overall, more scientific research is necessary to characterize the body burden of PFCs (especially for relevant subsets of the population) and the main sources and routes, which are responsible for human exposure and possible health implications of these compounds.

The impact of major heat waves on all-cause and cause-specific mortality in France from 1971 to 2003

Abstract: The aim of the study was to identify the major heat waves (HW) that occurred in France from 1971 to 2003 and describe their impact on all-cause and cause-specific mortality. Heat waves were defined as periods of at least three consecutive days when the maximum and the minimum temperature, averaged over the whole France, were simultaneously greater than their respective 95th percentile. The underlying causes of death were regrouped into 18 categories. Heatstroke, hyperthermia and dehydration were assigned to the “heat-related causes” (HRC) category. The numbers of deaths observed (O) during the identified HW were compared to those expected (E) on the basis of the mortality rates reported for the three preceding years. Six HW were identified from the period 1971 to 2003. They were associated with great excess mortality (from 1,300 to 13,700 deaths). The observations are compatible with a moderate harvesting effect for four of the six HW. The mortality ratios increased with age for subjects aged over 55 years and were higher for women than for men over 75 years. For the six HW, the excess mortality was significant for almost all the causes of death: (1) the greatest excess mortality (O–E) were observed for cardiovascular diseases, neoplasms, respiratory system diseases, HRC, ill-defined conditions and injury and poisoning, and (2) the mortality ratios (O/E) were highest for HRC, respiratory diseases, nervous system diseases, mental disorders, infectious diseases, and endocrine and nutritional diseases. Heat waves associated with excess mortality are not rare events in this temperate-climate country. The excess mortality is much greater than HRC mortality. Some populations are particularly vulnerable to HW: the elderly, women and people with some specific diseases. However, no segment of the population may be considered protected from the risks associated with HW.

Association between personal exposure to volatile organic compounds and asthma among US adult population.

Abstract: Objectives There is growing concern about adverse respiratory health effects from exposure to indoor air pollution. The purpose of this study was to analyze association between exposure to volatile organic compounds (VOC) and asthma in adults.

A 5-year follow-up study on respiratory disorders and lung function in workers exposed to organic dust from composting plants

Abstract: Objectives To evaluate acute and chronic effects of long-term exposure to organic dust on respiratory disorders and lung function among employees at 41 composting facilities in Germany.

Working conditions, adverse events and mental health problems in a sample of 949 German teachers.

Abstract: The aim of this study was (1) to explore in detail the working load of teachers, (2) to analyse the extent of negative or threatening school-related events teachers are confronted with, and (3) to evaluate mental health strain by applying the general health questionnaire (GHQ) A sample of 949 teachers in 10 grammar schools (German: Gymnasien) and 79 secondary modern schools (German: Hauptschulen) was investigated applying (1) a questionnaire covering different aspects of the occupational burden and threatening school-associated events and (2) the general health questionnaire (GHQ-12) Based on what teachers indicated in the questionnaire, full-time teachers work more than 51 h weekly More than 42% of our sample indicated verbal insults, almost 7% deliberate damage of personal belongings, and 44% threat of violence by pupils during the past 12 months When applying the GHQ-12, we found that 298% of the sample report significant mental health problems With respect to school types, teachers in secondary modern schools indicated more of such problems, while no effects regarding age, gender, or full/part-time teaching were observed To be a teacher is a hard work and requires coping of considerable amount of adverse events Based on the GHQ, nearly 30% of teachers suffer from significant mental health problems

Workdays, in-between workdays and the weekend: a diary study on effort and recovery.

Abstract: Objectives: Effort-recovery theory (Meijman and Mulder in Handbook of work and organizational psychology, Psychology Press/Erlbaum, Hove, pp 5-33, 1998 proposes that effort expenditure may have adverse consequences for health in the absence of sufficient recovery opportunities. Thus, insight in the relationships between effort and recovery is imperative to understand work-related health. This study therefore focused on the relation between work-related effort and recovery (1) during workdays, (2) in-between workdays and (3) in the weekend. For these three time periods, we compared a group of employees reporting relatively low levels of work-related effort ("low-effort group") and a group of employees reporting relatively high levels of work-related effort ("high-effort group") with respect to (1) activity patterns, (2) the experience of these activity patterns, and (3) health and well-being indicators. Methods: Data were collected among university staff members. Participants (Nhigh-effort group = 24 and Nlow-effort group = 27) completed a general questionnaire and took part in a 7-day daily diary study covering five weekdays and the following weekend. Differences between the two effort-groups were examined by means of analysis of variance. Results: Compared to the low-effort group, the high-effort group (1) engaged less often in active leisure activities during the week and worked more overtime in the weekend, (2) considered both work and home activities as more effortful, but not as less pleasurable, and (3) reported higher levels of sleep complaints (weekdays only) and fatigue, more preoccupation with work (weekdays only) and lower motivation to start the next workweek during the weekend. Conclusions: Work-related effort is associated with various aspects of work time and (potential) recovery time in-between workdays and in the weekend. High levels of work-related effort are associated with activity patterns that are less beneficial in terms of recovery, with higher effort expenditure during and after work time, and with diminished health and well-being. © Springer-Verlag 2007.

Occupational trichloroethylene exposure as a cause of idiosyncratic generalized skin disorders and accompanying hepatitis similar to drug hypersensitivities

Abstract: Workers exposed to trichloroethylene (TCE) rarely show severe generalized skin disorders and accompanying hepatitis which resemble drug hypersensitivities. The disorders are completely different from solvent-induced irritating contact dermatitis, and their serious consequences have become one of the critical occupational health issues recently in Asia. The present review sheds light on the analogous relationship between the reported patients’ clinical manifestations and those of severe drug rash, and provides a comprehensive picture of the disorder occurrences among TCE-exposed workers to date. All literature published in English and ad hoc publications in local languages were reviewed. The patients typically showed rash on the extremities, face, neck or trunk with/without fever 2 weeks to 2 months after commencement of occupational TCE exposure. Reported cutaneous manifestations were classified into two hypersensitivity categories, i.e. hypersensitivity syndrome and erythema multiforme/Stevens–Johnson syndrome/toxic epidermal necrolysis. Based on this categorization, 124 (52%) cases were classified as the former and 115 (48%) as the latter. According to the two spectra, the prevalence of each clinical finding of TCE-related skin disorders was close to that in drug hypersensitivities except for disease incidence and the prevalence of fever, hepatitis, and lymphadenopathy. Occurrences of the disorders have been reported from the USA, Japan, Spain, Singapore, China, Korea, Thailand, and the Philippines. The case reports from industrialized countries were mostly published up to 1990, whereas cases from Asian industrializing countries appeared thereafter. The TCE-related generalized skin disorders are important not only in terms of the number of disease occurrences and severity but from the viewpoint of drug hypersensitivity. Systematic collection of clinical information is necessary in cases diagnosed by the same criteria as those used for drug hypersensitivities. Detailed exposure assessments are also required to establish preventive strategies in these countries.

Differences in physical workload, psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models

Abstract: To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors. The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination. The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P < 0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35°/s vs 71°/s; P < 0.001) and wrist movements (20°/s vs 27°/s; P = 0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P = 0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P < 0.001). Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.

Economic activities and occupations at high risk for workplace bullying: results from a large-scale cross-sectional survey in the general working population in France

Abstract: Objectives To evaluate the prevalence of workplace bullying in the general working population in France, and explore this prevalence across economic activities and occupations.

Particulate air pollution and vascular reactivity: the bus stop study

Abstract: Particulate air pollution is associated with cardiovascular morbidity but mechanisms are not well understood. We tested the effects on vascular reactivity of exposure to fine particulates matter mass (PM2.5), number of particles ≤1 μm/m3 (PM1.0) and nitrogen dioxide concentration (NO2). About 39 healthy volunteers sat outside for 2 h at two different Ottawa bus stops. Flow-mediated vasodilation (FMD) of the brachial artery was then measured by ultrasound and expressed as: (maximum artery diameter after release of a blood pressure cuff inflated above systolic pressure—baseline resting diameter)/baseline resting diameter. A 30 μg/m3 increase in PM2.5 exposure corresponded to a 0.48% reduction in FMD, P = 0.05 representing a 5% relative change in the maximum ability to dilate. Results were consistent between the two bus stops and not sensitive to type of analysis. No significant association was found between FMD and NO2, PM1.0 or traffic density. PM2.5 may reduce the capacity to vasodilate, a potential explanation for the documented association with cardiovascular morbidity.

Relationship between repetitive work and the prevalence of carpal tunnel syndrome in part-time and full-time female supermarket cashiers: a quasi-experimental study.

Abstract: To investigate the prevalence of Carpal Tunnel Syndrome (CTS) in full-time and part-time supermarket cashiers exposed to a different weekly duration of biomechanical load. All the 269 cashiers and 127 office workers were asked to participate. The protocol included ergonomic risk assessment, collection of personal and clinical data and bilateral electrodiagnostic study of the median nerve. CTS symptoms were defined as past and/or current nocturnal and/or diurnal numbness, tingling, burning or pain involving at least one of the first three fingers. Results were evaluated according to two case definitions based on current symptoms and on the combination of current symptoms and slowing of sensory conduction velocity from wrist to palm, respectively. Difference in proportions of CTS symptoms and cases was evaluated by the Pearson’s chi-square (χ2) test, univariate and multivariate logistic regression analyses were performed to determine the impact of weekly exposure. The final female study population included 71 full-time cashiers, 155 part-time cashiers and 98 office workers. Ergonomic risk level was rated 5 for hand activity level and 4 for peak of force according to ACGIH. The intersection of the two values fell on the threshold limit value line, confirming the possible exposure to biomechanical risk factors for CTS. The prevalence of current CTS symptoms was higher among full-time (31.0%) than in part-time cashiers (19.3%) or controls (16.3%) (p = 0.055). A similar pattern was found for CTS past symptoms and cases. Univariate analysis showed that full-time cashiers had a 2.3 fold increased risk for CTS specific current symptoms than control subjects. A similar trend also emerged for CTS cases but was not significant (Odds ratios 1.23). Multivariate logistic regression analysis confirmed the increased risk for CTS current symptoms in full-time cashiers. Intensive manual work associated with inadequate recovery time might have generated an impairment of the median nerve at the wrist level proportionally increasing with duration of hand use. Our study can provide useful information both for ergonomic risk assessment and work organization.

Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results.

Abstract: Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants’ attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient’s history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.

Trait anxiety and modeled exposure as determinants of self-reported annoyance to sound, air pollution and other environmental factors in the home.

Abstract: We examined to what degree annoyance ratings to noise, air pollution and other common environmental factors in the home environment could be considered to mirror personality disposition in terms of habitual anxiety level and, when appropriate, objectively modeled noise and nitrogen emission (NOx) A trait anxiety scale was introduced in a cross-sectional public health survey with 2,856 respondents Of these, 705 had self-reported asthma and the rest constituted gender-matched referents Annoyance to ten specific factors in the residential environment, mainly focusing on source-specific noise and air pollution, was assessed on a six-point likert scale A-weighted energy equivalent continuous sound pressure level during a full day (24 h; L Aeq,24) as well as annual average NOx levels (μg/m3) at the residential address were modeled with high resolution, using a road data base and a detailed emission data base for NOx The two most prevalent complaints were annoyance to traffic noise and sounds from neighbors, which was reported by about 8% of the participants Unadjusted logistic regression analyses using the continuous trait anxiety score as a predictor showed positive associations with ratings of annoyance from total traffic noise, sounds from neighbors, sound from ventilation, exhaust fumes from traffic, sounds from other installations, and vibrations from traffic (ORs between 137 and 214) Modeled noise and NOx exposure were positively related with annoyance to traffic noise and exhaust fumes, respectively Adjustment of the trait anxiety scores for other individual characteristics and potential determinants did not change the overall pattern of results Trait anxiety scores were often mirrored in ratings of annoyance, which suggests caution when using annoyance reports either as a surrogate measure for environmental exposure on the individual-level in epidemiologic studies or when studying the moderating effects of annoyance on health outcomes

Evaluation of the interferon-γ release assay in healthcare workers

Abstract: An in vitro test for the diagnosis of latent TB-infection (LTBI) is now available that has the potential to replace the tuberculin skin test (TST). The new test measures the cell-mediated immune response to TB antigens. Little experience is currently available on the performance of the IGRA when testing HCW for LTBI. Therefore the aim of the study was to compare the IGRA with the TST in testing HCW for LTBI. The medical staffs of three hospitals were simultaneously tested with TST (RT23) and IGRA (QFT). The study comprises 261 HCW, all exposed to active TB-patients. Information on gender, age, workplace, BCG vaccination and history of both TB and TST were collected using a standardised questionnaire. The TST was positive in 24.1% and the IGRA in 9.6% of the participants. Agreement between the tests was low in HCW with a BCG-vaccination. A history of an earlier TST was a risk factor for a positive TST but not for a positive IGRA. Out of 48 results positive in the TST but negative in the IGRA 97.8% might be explained by BCG vaccination or an earlier TST. A positive association between age and LTBI was observed for the IGRA but not for the TST results. Out of 25 positive results in the IGRA only 60% were recognized by the TST, too. The HCW with a positive IGRA and a negative TST had the same age (mean 49.1) as the HCW positive in both tests (mean 50.9), which was higher than the age of those negative in both tests (mean 38.8). The data indicate that the IGRA should replace the TST in serial testing of HCW in high income, low incidence countries. The recommendations to use the IGRA in order to verify a positive TST only should be reconsidered.

Psychometric properties of the Korean version of the job content questionnaire: Data from health care workers

Abstract: To test the validity and reliability of selected scales, namely, decision latitude, psychological job demand, social support, job insecurity, and macro-level decision latitude from the Korean version of the job content questionnaire (K-JCQ), as part of a psychosocial epidemiological study among university hospital workers. K-JCQ was developed by translation and back translation complying with the JCQ usage policy, and its psychometric properties were explored among 338 workers (290 females and 48 males) in a university hospital in Korea. Internal consistency was examined using Cronbach’s alpha correlation coefficients. Factorial validity was tested using exploratory factor analysis. Pearson’s correlation coefficients were used for test–retest reliability among a subset of 157 workers who responded to a repeat survey. Criterion-related validity was assessed by investigating the effects of the scales on job satisfaction and self-identity through work in multiple regression models. Cronbach’s alpha for all selected scales was higher than 0.6, except for job insecurity (0.53) and macro-level decision authority (0.52), indicating appropriate internal consistency. Correlation coefficients between test and retest scales of decision latitude, psychological job demand, and social support were 0.60, 0.41, and 0.35, respectively. Exploratory factor analysis found three- and four-factor models, i.e., with and without macro-level decision latitude, respectively, closely corresponding to the theoretical constructs. High levels of decision latitude and social support, and low levels of psychological job demand and job insecurity were significantly associated with high level of job satisfaction. Higher self-identity through work was positively related to decision latitude and social support. These findings suggest that K-JCQ is valid and reliable for assessing psychosocial job stress among Korean workers. Macro-level decision latitude showed a separate factorial structure and was strongly associated with task-level decision latitude.

Work factors as predictors of poor sleep in nurses' aides

Abstract: Objectives The aim was to identify work factors that predict poor sleep in nurses’ aides (assistant nurses).

Inhalation and dietary exposure to polycyclic aromatic hydrocarbons and urinary 1-hydroxypyrene in non-smoking university students.

Abstract: Objective To examine which exposure pathway, dietary or inhalation, contribute more to the exposure to, and/or internal dose of, polycyclic aromatic hydrocarbons (PAHs) of non-smoking Japanese.

Contributions of occupational hazards and human factors in occupational injuries and their associations with job, age and type of injuries in railway workers

Abstract: To assess the contributions of environmental hazards, technical dysfunctions, lack of work organization, know-how and job knowledge, and other human factors in occupational injuries and their relationships with job, age and type of accidents in railway workers. The sample included 1,604 male workers, having had at least one occupational injury with sick leave during a 2-year period in voluntary French railway services. A standardized questionnaire was filled in by the person-in-charge of prevention, with the injured worker. Data analysis was performed via the χ2 independence test and adjusted odds ratios (OR) with Mantel–Haenszel test. The environmental hazards were implicated in 24.7%, technical dysfunctions in 16.0%, lack of work organization in 13.7%, lack of know-how in 17.6%, lack of job knowledge in 5.2%, and the other human factors in 31.9% of occupational injuries. The injuries caused by lack of know-how or job knowledge were more represented in workers aged less than 30 (ORs adjusted for job 1.45, 95% CI 1.02–2.06 and 2.06, 1.22–3.49, respectively), those by environmental hazards in energy and electrical traction maintenance operators and train drivers (ORs adjusted for age 2.04, 1.16–3.58 and 1.80, 1.01–3.20, respectively), and those by lack of work organization in mechanical maintenance operators and in energy and electrical traction maintenance operators (ORs adjusted for age 2.24, 1.13–4.45 and 1.83, 1.30–2.57, respectively). The causes considered were strongly related with the type of injuries. This study found that environmental hazards, technical dysfunctions, lack of work organization, lack of knowledge and other human factors had important contributions in injuries, and they were related to job, age and type of injuries. These findings are useful for prevention. Training is necessary for young workers. The occupational physician could help the workers to be more aware of the risks.

Fatigue, emotional exhaustion and perceived health complaints associated with work-related characteristics in employees with and without chronic diseases

Abstract: Ageing of the Dutch working force and increasingly more stringent restrictions regarding early retirement and disability benefits are leading to higher numbers of workers with ill health. Until now, only a few studies have explored how employees with ill health perceive their work. This study investigated possible differences in scores on fatigue, emotional exhaustion, perceived health complaints and various work-related characteristics between chronically ill (CIWs) and non-chronically ill workers (NCIWs), as well as differences in associations between work- and health-related characteristics. A questionnaire was sent to all employees of a Dutch university to collect data on perceived work-related and health-related characteristics (response 49.1%). Differences in various scores were analysed using χ 2-tests and the general linear model. Associations between the work- and the health-related characteristics were determined by multiple linear regression analyses in the CIWs (n = 444) and NCIWs (n = 1,347) separately. Interaction terms were included to detect differences between the two groups. The results indicated that the CIWs had less favourable scores on the three health-related characteristics. Also, the CIWs scored less favourably than the NCIWs on almost all the work-related characteristics. In the two groups, negative work-related aspects, such as higher work pressure, contributed most to explaining the variance in the health-related characteristics. However, in the CIWs, fatigue was not explained by the work-related aspects as much as in the NCIWs. In the CIWs, the association between unpleasant treatment and the health-related characteristics was stronger than in the NCIWs, but there were indications that autonomy, possibilities for learning and social support from superiors also played an important role. CIWs perceived more fatigue, emotional exhaustion and health complaints than NCIWs. There were different patterns of associations between work- and health-related characteristics in the NCIWs and CIWs. Future studies on associations between work-related characteristics and health should take the presence of chronic disease into account.

8-Hydroxydeoxyguanosine levels in human leukocyte and urine according to exposure to organophosphorus pesticides and paraoxonase 1 genotype

Abstract: In order to investigate a role of paraoxonase 1 (PON1) polymorphism in organophosphorus (OP)-induced 8-hydroxydeoxyguanosine (8-OHdG) levels, urinary metabolites of OP, PON1 genotypes, and 8-OHdG levels in leukocyte and urine were measured in OP indoor insecticide sprayers and controls in summer and winter. The study population contained 18 male sprayers and age-matched 18 male controls. Sprayers were primarily exposed to OP insecticides (mainly fenitrothion, dichlorvos, chlorpyrifos, and diazinon), and partially to pyrethroids (mainly permethrin) and carbamates (mainly propoxur). Urinary metabolites of OP were measured by gas chromatography-mass spectrometry. 8-OHdG levels in leukocyte and urine were measured by ELISA kit. PON1 genotype was identified using allele-specific fluorogenic TaqMan probes. The mean concentrations of urinary dimethyl phosphate (DMP) and total dialkyl phosphates (DAP) in summer and those of 8-OHdG in summer and winter were significantly higher in OP sprayers than controls. This resulted in a significant positive correlation between 8-OHdG levels and urinary DMP or DAP, suggesting a correlation between OP metabolites and production of oxidative stress. Of PON1 genotypes, incidences of Q/Q, Q/R, and R/R types were 17, 39, and 44% in OP sprayers and controls, respectively. Although PON1 polymorphism did not contribute to the leukocyte and urinary 8-OHdG levels, the urinary OP metabolite concentrations in summer showed a significant decrease as the number Q allele decreased. These results indicate that an increase in OP metabolites is associated with a high level of oxidative stress in OP sprayers, although the contribution of the PON1 polymorphism to the metabolism of OP is still unclear.

Air pollution, socioeconomic position, and emergency hospital visits for asthma in Seoul, Korea

Abstract: Some epidemiological literature has observed that air pollution effects on health differed across regional or individual socioeconomic position. This study evaluated whether regional and individual socioeconomic position, as indicated by health insurance premiums, modified the effect of air pollution on hospital visits for asthma. Effects of ambient air pollutants (particulate matter, carbon monoxide, sulfur dioxide, nitrogen dioxide, and ozone) on 92,535 emergency out-patient hospital visits for asthma in Seoul, Korea during 2002 were estimated using case-crossover analysis, adjusting for time trend, weather conditions, and seasonality. Next, interactions between air pollutants and Korean National Health Insurance premium (1) for the individual patient and (2) averaged across the patient’s residence district, were entered, first singly then jointly, in the models. Relative risks of emergency outpatient hospital visits were all positively and significantly associated with interquartile increases for selected lags for all air pollutants. In the regression model with interaction terms for both individual premium and regional-average premium, associations with all five-air pollutants ranged from 1.03 to 1.09 times higher among the lowest premium districts compared to the highest premium districts. Of all the pollutants, nitrogen dioxide showed the strongest associations in lower premium districts compared to the higher premium districts. Individual socioeconomic position did not modify the associations in either the single or joint interaction models. In Seoul, community but not individual socioeconomic conditions modified risk of asthma hospital visits on high air pollution days.

Comparative evaluation of biomarkers of occupational exposure to toluene

Abstract: This study was initiated to make comparative evaluation of five proposed urinary markers of occupational exposure to toluene, i.e., benzyl alcohol, benzylmercapturic acid, o-cresol, hippuric acid and un-metabolized toluene. In practice, six plants in Japan were surveyed, and 122 Japanese workers (mostly printers; all men) together with 12 occupationally nonexposed control subjects (to be called controls; all men) agreed to participate in the study. Surveys were conducted in the second half of working weeks. Time-weighted average exposure (about 8 h) to toluene and other solvents were monitored by diffusive sampling. End-of-shift urine samples were collected and analyzed for the five markers by the methods previously described; simultaneous determination of o-cresol was possible by the method originally developed for benzyl alcohol analysis. The toluene concentration in the six plants was such that the grand geometric mean (GM) for the 122 cases was 10.4 ppm with the maximum of 121 ppm. Other solvents coexposed included ethyl acetate (26 ppm as GM), methyl ethyl ketone (26 ppm), butyl acetate (1 ppm) and xylenes (1 ppm). By simple regression analysis, hippuric acid correlated most closely with toluene in air (r = 0.85 for non-corrected observed values) followed by un-metabolized toluene (r = 0.83) and o-cresol (r = 0.81). In a plant where toluene in air was low (i.e., 2 ppm as GM), however, un-metabolized toluene and benzylmercapturic acid in urine showed better correlation with air-borne toluene (r = 0.79 and 0.61, respectively) than hippuric acid (r = 0.12) or o-cresol (r = 0.17). Benzyl alcohol tended to increase only when toluene exposure was intense. Correction for creatinine concentration or specific gravity of urine did not improve the correlation in any case. Multiple regression analysis showed that solvents other than toluene did not affect the levels of o-cresol, hippuric acid or un-metabolized toluene. Levels of benzylmercapturic acid and un-metabolized toluene were below the limits of detection [limit of detections (LODs); 0.2 and 2 μg/l, respectively] in the urine from the control subjects. In over-all evaluation, hippuric acid, followed by un-metabolized toluene and o-cresol, is the marker of choice for occupational toluene exposure. When toluene exposure level is low (e.g., 2 ppm), un-metabolized toluene and benzylmercapturic acid in urine may be better indicators. Detection of un-metabolized toluene or benzylmercapturic acid in urine at the levels in excess of the LODs may be taken as a positive evidence of toluene exposure, because their levels in urine from the controls are below the LODs. The value of benzyl alcohol as an exposure marker should be limited.

Can sickness absence be reduced by stress reduction programs: on the effectiveness of two approaches.

Abstract: Objectives: The aim of the study was to evaluate the effectiveness of two brief preventive stress reduction programs - a cognitive focused program and a combined intervention of physical exercise and relaxation - on sickness absence in stressed and non-stressed employees working in various jobs in a telecom company. Methods: The study was designed as an a priori randomized trial and the follow-up period for sickness absence was 1 year. Sickness absence data of 242 employees were analyzed with respect to spells of sickness (frequency, incidence rate), days (length, duration) and time between intervention and first subsequent absent spell. Results: For stressed employees this study suggests that the illness burden represented by absenteeism is not affected by the interventions. There is no substantial difference in effectiveness between the cognitive and physical interventions. However, in comparison with the physical intervention the cognitive intervention decreases the period between the intervention and the first recurrence of a sick leave period with 144 days (marginal significant). Conclusion: The illness burden represented by absenteeism is effected in detail but not substantially by the interventions. © Springer-Verlag 2006.

Heart rate variability, hemostatic and acute inflammatory blood parameters in healthy adults after short-term exposure to welding fume

Abstract: The present study aimed to investigate, whether short-term experimental exposure to high levels of welding fumes would be capable of exerting acute effects in healthy subjects. Specifically, we assessed cardiovascular function in terms of heart rate variability (HRV) as well as the concentrations of inflammatory mediators and hemostatic proteins in blood as outcome measures. Twenty subjects without a history of airway and cardiovascular diseases were exposed to either control air or welding fume for 1 h on 2 separate days under standardized conditions. The median concentration of the alveolar particle fraction during welding was 3.5 mg/m3 (quartiles: 1.4–6.3 mg/m3; range 1.0–25.3 mg/m3). Five hours later a panel of clinical assessments was performed, including HRV measurement and drawing of blood samples. There were no changes in symptom ratings or lung function after welding fume exposure. Exposures did also not differ regarding effects on time- and frequency-domain parameters of HRV. Similarly, blood leukocyte numbers, cell differentials and the blood levels of fibrinogen, C-reactive protein, antithrombin III, factor VIII, von Willebrand factor, ristocetin cofactor, sICAM-1, tumor necrosis factor alpha, interleukin 6, interleukin 8 and epithelial neutrophil activating peptide 78 were not altered by welding fume inhalation. However, there was a significant fall in the level of endothelin-1 (P < 0.01). In conclusion, the data did not indicate effects of clinical significance of a short-term high-level exposure to welding fumes on HRV or a set of blood hemostatic and acute inflammatory parameters in healthy subjects. The small but statistically significant effect on endothelin levels demonstrated that measurable effects could be elicited even in these individuals. Overall, welding fumes are not likely to exert acute cardiovascular effects in healthy individuals.

Acute effects on heart rate variability when exposed to hand transmitted vibration and noise.

Abstract: OBJECTIVES: This study investigates possible acute effects on heart rate variability (HRV) when people are exposed to hand transmitted vibration and noise individually and simultaneously. METHODS: ...